Pancreas Flashcards
congenital anomaly: incomplete fusion of dorsal and ventral pancreatic buds/ducts; duct of santorini provides main drainage; may predispose to recurrent acute pancreatitis
pancreas divisum
congenital anomaly: head of pancreas incircles the duodenum; can cause duodenal obstruction; associated with pancreatitis, duct obstruction, peptic ulcers
annular pancreas
acute condition caused by inflammation and enzymatic necrosis of the pancreas resulting in acute onset of abdominal pain
actue pancreatitis
metabolic etiologic agents in actue pancreatitis
alcohol, hyperlipoporteinemia, hypercalcemia, drugs, genetic
mechanical etiologic agents in acute pancreatitis
gallstone, traumatic injury, perioperative injury
vascular etiologic agents in acute pancreatitis
shock, atheroembolism, polyarteritis nodosa
infectious etiologic agents in acute pancreatitis
mumps, coxsackie virus, m. pneumoniae
Most common causes of acute pancreatitis
alcohol, gallstones
edema, fat necrosis, parenchymal necrosis, hemorrhage, extra-pancreatic manifestations
acute pancreatitis
repeated episodes of mild to moderate inflammation with continued loss of pancreatic tissue and subsequent fibrosis; most common in alcoholic males
chronic pancreatitis
risks factors of which disease: alcohol, biliary disease, hypercalcemia and hyperlipidemia, pancreas divisum
chronic pancreatitis
calcifications associated with …
chronic pancreatitis
localized collection of pancreatic secretions that develop following inflammation; usually unilocular; lack a true epithelial lining; lined by fibrin and granulation tissue
pancreatic pseudocyst
4th leading cause of cancer death in US; high mortality rate
pancreatic adenocarcinoma
10% experience migratory thrombophlebitis (Trousseau’s sign); may have elevated serum CA19-9
pancreatic adenocarcinoma
pancreatic adenocarcinoma lesions of head (60%) often involve …, producing obstructive symptoms and jaundice
ampulla
25% of head tumors extend to …
duodenal wall
most functional (hormones released causes symptoms) neuroendocrine tumors are …
benign
most nonfunctional (hormones released by tumor do not cause symptoms) neuroendocrine tumors are …
malignant
associated syndrome of neuroendocrine tumors: hypoglycemia, high insulin levels
hyperinsulinism- insulinoma
associated syndrome of neuroendocrine tumors: recalcitrant peptic ulcer disease, gastric hypersecretion induced by gastrin, pancreatic islet cell tumor
zollinger-ellison syndrome (gastrinoma)
associated syndrome of neuroendocrine tumors: alpha cell tumor, increased glucagon
glucagonoma
associated syndrome of neuroendocrine tumors: delta cell tumor
somatostatinoma
associated syndrome of neuroendocrine tumors: watery diarrhea
VIPoma
70% women, associated with von Hippel Lindau syndrome, diabetes
serous cystadenoma
papillary proliferation of ductal epithelium with excessive mucin production, usually oozing from ampulla of vater, with ductal dilation; treatment resect entire tumor; complex papillary fronds
intraductal papillary mucinous neoplasm
heterogeneous groups of disorders of the endocrine pancreas sharing hyperglycemia as a common feature
diabetes mellitus
immunologically-mediated destruction of b-cells
diabetes mellitus type 1
insufficiente insulin secretion relative to glucose load; insulin resistance of peripheral tissues
type 2 DM
reduction in size and number of islets
type 1 DM
amyloid replacement of islets
type 2 DM
polyuria (increased urination), polydipsia (increased thirst), polyphagia (increased hunger)
DM
microangiopathy, atherosclerosis, neuropathy, nephropathy, retinopathy
DM
seen exclusively in type 1 DM; severe insulin deficiency; often precipitated by stress
diabetic ketoacidosis
type 2 DM, dehydration from hyperglycemic diuresis; glucose usually higher than 600 mg/dL
nonketotic hyperosmolar coma
DM diagnosis: random glucose greater than or equal to … with classical signs and symptoms
200 mg/dL
DM diagnosis: fasting glucose greater than or equal to … on more than one occasion
126 mg/dL
an abnormal …, in which the glucose is greater than or = to 200 mg/dL 2 hrs after a standard carb load
oral glucose tolerance test (OGTT)
hemoglobin A1C greater than or = to …
6.5%